B.C. medical students call for more residency spots to curb doctor shortage

After upwards of five years pursuing an undergraduate degree and four years of medical school, about a dozen UBC graduates will get the crushing news this year they didn’t land a residency.

Being trained under a residency program is the next step in becoming a practicing doctor in Canada.

After passing medical school, graduates are interviewed at various hospitals in Canada – their academic and personal lives dissected – in hopes of getting placed in a program to train in a specialty ranging from family medicine to neurology.

An average of 14 graduates in B.C. do not get a placement, even despite a second round of matching for remaining spaces that includes grads from out of the country. They are forced to wait a year and apply again, against new graduates.

The number of hopeful doctors being left behind have been steadily growing over the last decade in B.C.

Now, a group of students and alumni are calling on the B.C. government to fund more residencies to increase the number of practicing doctors, especially as the province deals with a doctor shortage.

No Docs Left Behind, organized by members of the Medical Undergraduate Society, estimates that for every unmatched graduate, 1,875 patients in the province lose out on stable health care. That’s 26,250 patients each year.

John, who asked that his real name not be used to protect his chances for a future residency, found out on Monday at 9:27 a.m. he had not been matched.

“I remember feeling like everything was over, like I had just been abandoned and discarded by my country,” he told Black Press Media. “Like I had no future. I felt like I was in a black box, basically.”

The 26-year-old said he’s put nine years of his life into building a career in medicine. He declined to say which specialty he had applied for, but explained it was niche and highly competitive.

“When I leave my home, it takes me every bit of effort not to cry. Because every time I go back to school or an extra curricular activity with friends from school, all I see are their smiling faces, and I don’t have that.”

There is a sliver of hope: John could be selected for a residency in a second and final round of matching, but he’s up against higher competition and fewer spots. Those results won’t be known until April.

If he doesn’t get in anywhere, John said he has two options: Leave his family and apply for international training, running the risk of never practicing in Canada, or find a job that allows him to start paying off his mounting debt and apply again next year.

“What makes it difficult is that I don’t just lose a year where I have no income, am not really a student either, and somehow expected to start paying my debt,” he said. “But this also means that when I apply next year…, I’m basically damaged goods because I didn’t match the first time and people will wonder why.”

Privia Randhawa, senior chair of the society behind No Docs Left Behind, said the residency matching process is a key step in a career as a physician, but it’s often misrepresented as vetting grads based on their capabilities.

“Each graduate, especially here in Canada because the standards are so high, are competent students,” Randhawa said. “They have passed their medical exam, they passed clinical exams which are both structured and standardized. If a student wasn’t competent to make the cut, they wouldn’t be at the position to apply to be looking for a spot.”

Randhawa, who’s in her second year of medical school, said this is one of many reasons why the province needs to fund additional spots.

Across Canada, 68 graduates weren’t matched with programs last year, compared to just 11 in 2008.

“Because we’ve been seeing physician shortages across the country, both in urban or rural areas, this has been getting worse,” Randhawa said. “So medical schools have been pushing to increase their enrollment in order to alleviate the position shortage, but residency spots haven’t increased in an equal way.”

UBC medical students calculate that each doctor in B.C. can provide stable health care to 1,875 patients. (No Docs Left Behind graphic)

Residency positions in other provinces have also been cut, including 50 in Ontario. Some programs in Quebec are solely French-language. Both put further pressure on the system.

The government invests $250,000 to train a medical graduate in a residency, and the funds are not transferable between specialties. That means the money can go unused if a spot is left unfilled.

As it stands, there are 285 medical graduates each year from UBC, and an average of 12 prior-year medical students, who apply for 288 residency positions at the university.

Physician shortages have led to long wait times at hospitals and clinics shutting down across B.C.

Health Minister Adrian Dix has introduced legislation to increase access to timely treatment, including urgent primary care centres. In 2018, he announced $181 million over three years to recruit 200 medical resident graduates into B.C. jobs.

His ministry was unable to return requests for comment Friday, saying Dix was travelling.

No Docs Left Behind is advocating for two solutions: For B.C. to boost the number of positions available to 317, and create any needed residency positions for all unmatched medical graduates each year.

“A lot of ministries and provincial governments are working to increase their spots, but B.C. has yet to do anything,” Randhawa said.

She and a group of graduates and students plans to demonstrate at the B.C. Legislature on Monday and meet with MLAs.

She wants to send a message about making the system better for once she and her peers graduate, and for all those who pursue the medical field after her.

“Our ultimate goal in all of this, is to better help the B.C. population with their health care. As medical students, we are not able to do that if we can’t finish our training.”